Cirrhosis

Question 1

Definition

Answer 1

Chronic damage to the liver which leads to permanent fibrosis

Question 2

Causes

Answer 2

• Alcohol
• Hemochromatosis (build up of iron in the blood over a long period of time)
• Hepatitis
• NAFLD
• Auto-immune disease
• Wilson’s disease- XS copper
• Drugs
• CF
• Vascular problems

Question 3

Treatment

Answer 3

Treat underlying cause e.g. take away alcohol, virus

Question 4

Investigation

Answer 4

Biopsy of the liver:

• AST/ALT
• Gamma GT
• Bilirubin levels may be impaired
• Reduced platelet count

Question 5

Complications

Answer 5

• Jaundice
• Variceal hemmorage
• Ascites
• Hepatic encephalopathy
• Easy bruising
• portal hypertension
• Hepatocellular carcinoma

Question 6

Ascites

Answer 6

• Build up of fluid in the peritoneal cavity
• Investigation: shifting dullness, Paracentesis (examine fluid for serum albumin levels), CT, Ultrasound
• Symptoms: fetor hepaticus (mouldy breath), increased JVP
• Treatment: diuretics and paracentesis

Question 7

Variceal hemorrage

Answer 7

Varices (dilated veins) at porto-systemic anastomosis

Treatment: banding, sleropathy, shunting

Question 8

Hepatic encephalopathy

Answer 8

Damage to brain due to reduce detoxification function in the liver.
Symptoms:
-asterixes=flapping tremor
-Increased oestrogen symptoms e.g. spider nave, palmar erythema
-Confusion

Question 9

Jaundice

Answer 9

Reduced function of liver leads to reduced production of bilirubin in the liver

Question 10

Portal hypertension

Answer 10

Build up of pressure in the portal veins due to fibrosis- narrowing

Question 11

Classification of Cirrhosis

Answer 11

Compensated: 
-little fibrosis 
-Mostly asymptomatic 
Decompensated: 
-Heavy fibrosis 
-Symptoms begins to present